Lip cancer: symptoms, treatment, signs of the initial stage

Lip cancer can not be called common pathology of all malignant tumors it occupies a modest 9th place. However, we should not forget about the possibility of its occurrence, especially in the elderly, who more than anyone is exposed to various tumors.

Among lip cancer patients is dominated by men and the average age of the patients ranges between 60 and 70 years old. With age, immune protective mechanisms are reduced, spontaneous mutations accumulate, and this is the way to cancer of any localization. The vast majority of cases, the tumor grows on the lower lip (over 95%), while the upper lesion is diagnosed only 2-5% of patients. Although the overall disease – inheritance of the male population, but it is worth noting that cancer of the upper lip more often affects women.

Analysis of the incidence shows that cancer of the lip are more vulnerable than rural residents. Perhaps this is due to more intense and prolonged exposure to aggressive external environmental factors in farm work, often associated with being in the sun, under the action of wind, fluctuating temperature, etc.

Lips being located on the face, easily accessible to inspection, therefore any changes cannot go unnoticed. It would seem that cancer should be detected in the early stages, when treatment is very effectively. In many countries, where the population is very concerned about your health at least for economic reasons, what happens. Systematic surveys allow at an early stage to suspect a malignant process and to take all measures for its elimination. Most residents of the former Soviet Union is not a habit, so often patients come to the doctor when the disease, as they say, «squeeze». To expect a favorable outcome in severe cases is not necessary, because there is a perception that cancer is incurable and, therefore, to the doctor and don’t rush.

Self-medication, and alternative medicine, often accompanied by tumor progression and development of complications, so do not delay visit to the doctor if there are any disturbing changes of the upper or lower lip.

The smoke without fire does not happen…

We all know that in nature every phenomenon has a reason. And in the case of cancer, which almost never occurs in healthy tissues. Predisposing factors to malignant tumors of the lip are all kinds of external influences that could lead to a violation of division and maturation of the surface epithelium cells, provoke chronic inflammation and other changes.

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Among the causes of cancer are particularly important:

  • Adverse weather conditions – wind, insolation, air temperature fluctuations, ionizing radiation.
  • Bad habits – cancer from Smoking, chewing tobacco and various blends.
  • Damage to the lips with injuries, chronic inflammation, pathology of the teeth and biting of lips, burns when eating or Smoking.
  • The presence of a viral or fungal infection.
  • Professional harmful factors (contact with arsenic, mercury, refined petroleum products etc.).
  • Congenital defects of the lips (pragmatism).

For anybody not a secret that Smoking causes a variety of tumors. Inhalation is not only the contact of the mucosa with the carcinogens, but also the local high temperatures that have a damaging effect on the epithelium of the lips.

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Fans of chewing mixtures should also know that the risk of lip cancer in this case increases significantly. Of course, burns is unlikely to occur, but contained in nasvay and other mixtures of slaked lime, tobacco, ashes are pretty strong carcinogens. In addition, the composition of nasvai is often included chicken manure used in agriculture, diluted, while in the chewing mixture is added in pure form, which makes it extremely toxic and dangerous. Teenagers and adults who are fond of such bad habits should know that cancer of the lip occurs from chewing/Smoking tobacco and nasvai.

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Pre-cancerous changes on the lips are divided into an optional pre-cancer that will not necessarily result in a malignant tumor, and obligate, sooner or later turning into carcinoma.

Optional precancer believe cheilitis (inflammatory process), the presence of long nonhealing ulcers and cracks, papilloma and leukoplakia. Obligate precancer is cheilitis, Manganotti, limited hyperkeratosis, etc.

Precancerous changes long time can mask the presence of a malignant tumor, manifested by peeling, scabs and scales, erosions and cracks or nodules pink in color without bleeding. Nonhealing lesion of the vermilion border should always be alerted and be the reason for going to the oncologist.

Cancer never appears on a healthy lip. Originating in the damaged epithelium, it is showing signs of exophytic (verrucous, papillary variants) or endophytic (ulcerative, ulcerative-infiltrative) growth. The latter is typical for undifferentiated and very malignant carcinoma.

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lip cancer: 1 — papillary form, 2 ulcer, 3 — ulcerative-infiltrative

Since the source of the tumor acts as stratified squamous surface epithelium, the most characteristic histological variants are squamous keratinizing and neorogovevayuschy cancer. Keratinizing cancer grows relatively slowly and metastasizes late, unlike neorogovevayuschy, prone to rapid endophytic growth with the defeat of the subject and surrounding tissues, and early dissemination to the regional lymph nodes.

Cancer of the lower lip occurs more favorably than the top, which is connected with the peculiarities of lymphatic drainage, and therefore metastases will appear much later.

Tumors arising in young people, especially men, tended to become more aggressive course than the elderly, though quite rare.

Signs of malignant tumors of the lips

Symptoms of lip cancer can stay hidden in the background of existing precancerous lesions, but careful inspection shows sign of suspect tumor at an early stage.

The main features of carcinoma can be considered:

  • The presence of the seal of the nodule or ulceration on the surface of the vermilion border.
  • Drooling.
  • Pain.
  • Visible defects and violation of the anatomy of the lips.
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    lip cancer in the initial stage

    Attempts to conservative or home treatment not only not bring positive results, but are associated with increased tumor size and the worsening of symptoms.

    The initial stage of lip cancer is characterized by the appearance of the seal, nodules or plaques, covered with grayish crusts, the separation of which is quite painful. Under the cork you can see lumpy growths red colour, which over time increase in size, merge with each other and become similar to cauliflower.

    When the necrosis of fragments of the tumor appears ulcer with jagged edges, and infiltration of malignant cells to surrounding tissues and a pronounced secondary inflammation lead to pain and spread destruction on the cheek, chin and jaw.

    Over time the size of the lesion increase, an increasing volume of surrounding tissue involved in the pathological process, patients experience pain, difficulty eating, drooling.

    The first signs of the tumor, such as a seal or long unhealed defects of the epithelium should be alerted, and to go to a specialist, because only early treatment can give the chance of a successful outcome of cancer.

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    photo: various stages and forms of the current progressive cancer of the lip

    With further progression of the tumor, it is possible to feel enlarged submandibular, chin the lymph nodes, which is a sign of metastatic cancer. Patients in advanced stages lose weight until exhaustion (cancer cachexia), experiencing pronounced weakness, prone to fever and other signs of intoxication.

    Late stage of tumor growth appears as large ulcer or a node with a rough surface, pockets of decay, the invasion of neoplasia of the surrounding tissues, accompanied by severe pain. Late stage diagnosis of cancer is no longer in doubt.

    Diagnosis of lip cancer

    The cornerstone of modern cancer remains early detection of tumours. According to statistics, about 16% of patients with lip cancer come to the doctor already in the III-IV stage of the disease, when to expect a favorable outcome is impossible. Meanwhile, stage I detected tumors allows to achieve not only positive result of therapy, but full recovery.

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    stages of lip cancer by TNM classification, stage 4 is caused by the metastasis of tumors to other organs

    Factor, facilitating the diagnosis of cancer of the mucous membrane of the lips is their good accessibility examination that does not require any special tools, and the patient himself may house to smell a rat.

    Turning to the oncologist the minimum necessary surveys will:

    • A detailed survey asking when and how any changes in the lips, whether treatment and what is its result, the dynamics of the disease, the presence of harmful habits, etc.
    • Inspection of the affected area, the better – with a magnifying glass.
    • Palpation of the area of tumor growth, jaw, cheeks, chin area and regional lymph nodes.
    • Cytological examination of smears or biopsy with subsequent histological examination of tissue.

    Examination patients also involves the analysis of blood, urine, ECG, chest x-ray to exclude metastases, ultrasound examination of the lymph nodes and other clarifying diagnosis procedure.

    Reliably confirming the presence of malignant tumors by the method can be considered a histological examination, by which it is possible to set a specific type of cancer the mucosa of the lips, degree of malignancy and prognosis.

    Treatment

    The choice of methods of treatment of cancer of the lip is determined by the stage of disease, patient’s age and presence of comorbidity, which can be a contraindication to surgery or radiation therapy.

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    I-II stages of cancer, it is possible to achieve a full and stable recovery, and it needs to handled in a timely manner to the specialist oncologist. Unfortunately, not a rarity in our days, when patients delay a visit to the doctor, use all kinds of folk remedies, soda, etc., but the expected positive effect of this treatment can not be, the tumor will progress and move to the next stage.

    Among the ways of dealing with lip cancer include:

  • Cryotherapy and laser therapy.
  • Surgery.
  • Radiotherapy.
  • Chemotherapy.
  • In the early stages of the tumor when metastases yet, and the primary lesion is small in size, used cryogenic impact or laser therapy (photodynamic treatment).

    Cryotherapy is done using liquid nitrogen, which has very low temperature and freezes the cancer cells, thus destroying them. This method is very effective in the first stages of the disease, and in elderly patients in whom surgery or other treatment is contraindicated for other reasons. In addition, this manipulation can be spent in the clinic, it is easy to hold and available.

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    Laser therapy is applicable when the limited superficial lesions in the mucosa of the lips, and before the procedure, the patient is intravenously administered a special photosensitizing substance that increases the sensitivity of tumor tissue to the laser.

    Surgical surgery is indicated in advanced cases of the disease, and the presence of metastases in regional lymph nodes. In this case remove the tumor within healthy tissue, tissue of the neck, and sometimes the supraclavicular lymph nodes, neurovascular bundles, sternocleidomastoid muscle.

    It is worth noting that the larger size of the tumor, surgical treatment can be very traumatic and be accompanied by a significant cosmetic defect that will require further plastic surgeries.

    Radiotherapy can be applied at all stages of the malignant tumors of the lips, both before and after surgery. The irradiated neck, chin, and submandibular lymph nodes. At the last stage of the disease, radiation exposure becomes the basis of palliative treatment aimed at alleviating the suffering of the patient and the prolongation of life.

    Tumors of the lips do not have a high sensitivity to anticancer drugs, therefore the use of chemotherapy was limited to the distant hematogenous metastases (e.g. lungs) to combat the secondary tumor nodes. For these purposes, administered cisplatin, methotrexate, and fluorouracil.

    Overall, cancer of the lip is not the most formidable of all cancers. He pretty well treatable, and early diagnosis is possible with careful patient’s attitude to their health. With proper and adequate scheme of treatment of tumors in I-II stage with all possible modern means possible to achieve complete cure in almost all patients. In the third stage cured up to 80% of patients, and only the fourth, most severe stage of the disease gives chance to recover a little more than half of the patients.

    In order to avoid the appearance of the tumor, should adhere to simple rules:

    • See your doctor regularly and undergo periodic health examinations.
    • To monitor the condition of the oral cavity, dentures and prevent trauma to the mucous membrane of the lips from the sharp edges of the patients teeth.
    • Promptly treat precancerous and any inflammation of the lips.
    • Eliminate bad habits, especially Smoking or chewing mixture.
    • To use protection when working in hazardous environments or in conditions of exposure to adverse weather conditions.

    Compliance with these simple rules will greatly reduce the likelihood of lip cancer, especially in predisposed individuals, and the attentive and caring attitude, and timely expert advice in the case of suspected tumor will give hope for a cure.